Slept for about 8.5 hours last night. Woke up very groggy and almost confused. Was just a major fog. It's 8:30 pm and the only thing I've taken so far is the Aspirin (for circulation). Although I'm not in miserable pain like before, my body is very uncomfortable with keeping leg up all the time. I'm shifting every 10 minutes probably.
I did go out to the living room today and watch some tv. Also ate out there. First time since back from hospital.
I can definitely feel the effects of all the drugs I've been on. My brain is very slow and my vocabulary is a bit limited. I'll probably take a diazepam tonight before bed so I can sleep. I go to the doctor tomorrow at 9am to get the surgical cast removed, stitches out, and new cast put on. I'm a bit nervous as I've read in a few posts that it's pretty painful. I may just take a valium in the morning and keep an Oxy IR in my pocket in case I'm really hurting.
Thursday, March 31, 2011
Wednesday, March 30, 2011
Day 10 (March 30)
Still making progress. Have cut out the Oxycodone SR and almost all of the Oxycodone IR (only took 1 dose late at night). Only taking 1 Norco per 4 hours. Ankle and foot hurt when elevated but it's tolerable. Absolutely miserable when lowered and using crutches. Trying to wiggle toes every hour or more.
Tuesday, March 29, 2011
Day 9 (March 29)
Today the pain is beginning to subside and I cut back on the Norco. I also cut out a dose of the Oxycodone IR in the evening. Still taking other meds though. I'm also getting up to use the bathroom. Don't want to risk a blood clot.
Monday, March 28, 2011
Day 8 (March 28)
Still in a lot of pain. Taking all meds as scheduled. Spent day in bed. Once again, keep a log of when and which medicines you take. Also, I kept 3 liters of water by my bed in the evenings as I wanted to stay hydrated and everyone else was asleep.
Sunday, March 27, 2011
Day 7 (March 27)
Doc stopped by again to check on ankle and said I should be fine to go home. They want me to stay on same pain meds as in hospital (not the dilaudid though).
Disposable sanitizing/moisturizing clothes
Extra hospital gown
2 urinals
Little pink plastic pan for using after brushing teeth
4 of the paper ice bag things
Couple of the body washes and lotions
On very strict pain med schedule as leg kills if I don't stay on top of it. Here's an example of 24 hours:
21.5 pain pills total. I could have taken the Oxycodone IR every 3 hours (instead of 4) but I didn't need to. Here's a pic of the sheet I kept next to my bed. It has the instructions for each medication and the anticipated schedule. I would just circle the time I took the pill or write in the time. Worked very well, even in my drugged state.
12 am
2 5 mg Oxycodone IR (instant release)
2 am
2 10/325 Norco
3 am
1 5 mg Diazepam (valium)
4 am
2 5 mg Oxycodone IR
6 am
1 10/325 Norco
8 am
2 5 mg Oxycodone IR
9 am
1 5 mg Diazepam (valium)
10 am
1 10 mg Oxycodone SR (extended release)
2 10/325 Norco
11 am
325 mg aspirin
12 pm
2 5 mg Oxycodone IR
2 pm
1 10/325 Norco
3 pm
1 5 mg Diazepam
4 pm
2 5 mg Oxycodone IR
6 pm
2 10/325 Norco
8 pm
2 5 mg Oxycodone IR
9 pm
1 5 mg Diazepam
10 pm
1 10 mg Oxycodone SR
1 10/325 Norco
11 pm
325 mg aspirin
Saturday, March 26, 2011
Day 6 (March 26)
Cutting back on some of the pills but still taking dilaudid shots. Pain still goes from a 5 to 8/9. My surgeon stopped in and said I should be able to leave the next morning. I asked him if I was just a total sally for having so much pain and he said absolutely not. It really varies for each person. Some people have moderate to severe pain and others have severe. Every person reacts differently. I emphasized that I felt like such a baby and he started to get mad. He said that he should have explained the procedure in more detail before the surgery and what to possibly expect afterwards. He said the procedure should have been in-patient.
Thursday, March 24, 2011
Day 4 - 5 (March 24 - 25)
Mostly a blur. I remember the pain coming and going. It would go from a 5 after injections to a 8 or 9. I can't really remember too much. In reflection (even now), I think I was very social and went to other peoples rooms but that is all a dream. I guess an effect of dilaudid.
The nurse did tell me that she really doesn't understand how they can do these surgeries outpatient. She said they are always much more painful for men then women (calcaneal osteotomy) and she gets people in all the time. That made me feel a little better.
Going to the restroom was miserable. The nurse would escort me and then leave once I was settled. Unfortunately, the pain in my ankle/foot would come out of nowhere and the first few times I actually screamed which would cause the nurse to come in running.
While in the hospital, they were giving me:
Dilauded shot every 3 - 4 hours
Oxycodone SR (10mg), 1 pill twice a day
Oxycodone IR (5 mg), 2 pills every 3 hours
Lortab (10/500), alternating 1 pill then 2 pills in between the Oxycodone (not replacing, but 2 hours after each does of Oxycodone IR)
Diazepam (5mg), 1 pill every 6 hours
This leads to a bit of a funny/scary note. Be careful if you have your phone or computer. I reread some of my correspondence and it was humorous and embarrassing.
The nurse did tell me that she really doesn't understand how they can do these surgeries outpatient. She said they are always much more painful for men then women (calcaneal osteotomy) and she gets people in all the time. That made me feel a little better.
Going to the restroom was miserable. The nurse would escort me and then leave once I was settled. Unfortunately, the pain in my ankle/foot would come out of nowhere and the first few times I actually screamed which would cause the nurse to come in running.
While in the hospital, they were giving me:
Dilauded shot every 3 - 4 hours
Oxycodone SR (10mg), 1 pill twice a day
Oxycodone IR (5 mg), 2 pills every 3 hours
Lortab (10/500), alternating 1 pill then 2 pills in between the Oxycodone (not replacing, but 2 hours after each does of Oxycodone IR)
Diazepam (5mg), 1 pill every 6 hours
This leads to a bit of a funny/scary note. Be careful if you have your phone or computer. I reread some of my correspondence and it was humorous and embarrassing.
Wednesday, March 23, 2011
Day 3 (March 23)
Take norco at 1240 am, really drowsy. Sleep (or drug induced haze) until 215 am. Take an oxy and sleep/haze until 345. Ankle is not responding to pain medication and I am in complete agony. Take norco at 4am. Due to take another norco at 5 but am nervous about getting too close to 4 grams of acetaminophen in 24 hours. Please see the importance of keeping a log of your drug intake as this is critical. Acetaminophen poisoning is not a fun way to die (or so I've read)! Decide to take an oxy at 5 am instead. Ankle is burning and whole foot feels like it is going to burst. At 530 am, I am very drowsy but do not have relief from pain. Plan to call doctors office in the morning to see if alternate pain management program is available. Not sure how much my previous use of Norco is impacting the effectiveness of pain killers.
I think I slept from 630 to 730am. Woke up in even more pain than before. I call the doctors office at 8:05 and leave a message for surgical nurse. She calls back 5 minutes later and says she will write another script for Oxycodone SR (extended release). She also says that we may want to consider going to ER to get pain under control. My mother, who is taking care of me but can not drive, is getting very worried. At 8:30, a sibling agrees to pick up script. At 9 am, I call sibling again and leave a voicemail that I just need to go to ER. This is horribly embarrassing but there were tears flowing. I'll mention it again, I'm 34, have had multiple surgeries in the past, have even walked around on a broken leg for a week before going to doctor, have had my finger tips (flesh and bone) crushed off in a steel door, and nothing compares to what I'm going through. At 10:30 am, I'm going to call an ambulance to take me to ER. My mother says she can drive and loads me in car.
ER:
I would like to note that I'm fortunate to live in a town that is known for its hospitals. I arrive at 11am and security guard wheels me into admitting area. I provide my date of birth and name. One minute later, I am moved into triage where nurse takes vitals. 2 minutes later, I am wheeled into an ER room. I can't even look at people at this point. 1 minute later, the ER doc comes in, does an exam and asks questions. I hate to admit it again, but the tears are rolling. Fortunately, I brought my medication log which greatly helped his ability to prescribe additional pain medication. He said he would put a call in to the orthopedic resident and order me a shot of dilaudid (hydromorphone). For those not familiar with meds, look it up, strong stuff (I believe it is second to fetanyl). 20 minutes later, a nurse came in and injected me in hip. Could only give me half the normal dose due to the amount of meds already in my system. Shot didn't do anything for pain. At this point, things are getting a bit fuzzy. Ortho resident then came in, cut open the top of my surgical cast to make sure it wasn't too tight and to inspect leg. ER doc came back in and ordered more pain shots. I don't remember this but I guess I was still writhing in pain so they kept pumping me up with shots. After a few hours, they called in the head of pharmacology who put together a super cocktail of pain killers. I was told it finally worked.
Ortho resident wanted to get an x-ray of ankle to make sure nothing had shifted. I remember being nervous but they were very gentle and used a machine that moved around me and provided immediate digital images. Everything looked fine.
ER doc then came in and said they need to admit me in order to keep pain under control. They put in IV and wheeled me up to room. I remember telling the nurse that they had a hard time getting my pain under control and she laughed at me saying that doesn't even being to explain it. She was amazed by the amount of meds they had to give me.
I think I slept from 630 to 730am. Woke up in even more pain than before. I call the doctors office at 8:05 and leave a message for surgical nurse. She calls back 5 minutes later and says she will write another script for Oxycodone SR (extended release). She also says that we may want to consider going to ER to get pain under control. My mother, who is taking care of me but can not drive, is getting very worried. At 8:30, a sibling agrees to pick up script. At 9 am, I call sibling again and leave a voicemail that I just need to go to ER. This is horribly embarrassing but there were tears flowing. I'll mention it again, I'm 34, have had multiple surgeries in the past, have even walked around on a broken leg for a week before going to doctor, have had my finger tips (flesh and bone) crushed off in a steel door, and nothing compares to what I'm going through. At 10:30 am, I'm going to call an ambulance to take me to ER. My mother says she can drive and loads me in car.
ER:
I would like to note that I'm fortunate to live in a town that is known for its hospitals. I arrive at 11am and security guard wheels me into admitting area. I provide my date of birth and name. One minute later, I am moved into triage where nurse takes vitals. 2 minutes later, I am wheeled into an ER room. I can't even look at people at this point. 1 minute later, the ER doc comes in, does an exam and asks questions. I hate to admit it again, but the tears are rolling. Fortunately, I brought my medication log which greatly helped his ability to prescribe additional pain medication. He said he would put a call in to the orthopedic resident and order me a shot of dilaudid (hydromorphone). For those not familiar with meds, look it up, strong stuff (I believe it is second to fetanyl). 20 minutes later, a nurse came in and injected me in hip. Could only give me half the normal dose due to the amount of meds already in my system. Shot didn't do anything for pain. At this point, things are getting a bit fuzzy. Ortho resident then came in, cut open the top of my surgical cast to make sure it wasn't too tight and to inspect leg. ER doc came back in and ordered more pain shots. I don't remember this but I guess I was still writhing in pain so they kept pumping me up with shots. After a few hours, they called in the head of pharmacology who put together a super cocktail of pain killers. I was told it finally worked.
Ortho resident wanted to get an x-ray of ankle to make sure nothing had shifted. I remember being nervous but they were very gentle and used a machine that moved around me and provided immediate digital images. Everything looked fine.
ER doc then came in and said they need to admit me in order to keep pain under control. They put in IV and wheeled me up to room. I remember telling the nurse that they had a hard time getting my pain under control and she laughed at me saying that doesn't even being to explain it. She was amazed by the amount of meds they had to give me.
Tuesday, March 22, 2011
Day 2 (March 22)
Please note that I wrote this while on a pretty heavy dose of pain killers.
Took a norco at 1:30 am and another 1/2 at 2 am. Finally fell asleep around 3 am, was not really having much pain yet but I could begin to feel nerve block wear off (slight tingling in calf). Woke up at 530 am and took 1 norco and another 1/2 at 6:30. Still no major pain but continue to feel nerve block wear off. Guessing when the nerve block will wear off is the most frustrating part so far. Most of the reports I read online (so take it with a grain of salt) say the nerve block doesn't typically fade, it will begin to wear off and then be gone in an hour.
Took a norco at 1:30 am and another 1/2 at 2 am. Finally fell asleep around 3 am, was not really having much pain yet but I could begin to feel nerve block wear off (slight tingling in calf). Woke up at 530 am and took 1 norco and another 1/2 at 6:30. Still no major pain but continue to feel nerve block wear off. Guessing when the nerve block will wear off is the most frustrating part so far. Most of the reports I read online (so take it with a grain of salt) say the nerve block doesn't typically fade, it will begin to wear off and then be gone in an hour.
Toes are still numb and continue to feel block wear off (tingling on inside of ankle). Still no major pain. Took a norco at 10 am, 1/2 at 1030 am.
Throughout the course of the day, the block was fading but only on inside of ankle (not the surgical side) and calf muscle. Definitely tolerable.
227 pm, I take a oxycodone 5 mg.
4 pm, block fades completely and my heel and ankle are on fire. I have never experienced pain like this in my life. Almost to tears. Bear in mind what I mentioned about my history and familiarity with surgeries and pretty intense pain. I am very used to pain but nothing like this. It feels like someone is inserting a molten hot wedge into my heel. I take a norco at 417 pm. I call pharmacist to see if I can take more drugs. Pharmacist says I can either take 2 of the oxycodones and then a norco to break through pain or 2 of the norcos and an oxy to break through pain. As I'm familiar with the norcos, I decide my approach will be 2 norco and 1 oxy.
Take an oxy at 6 pm, still in tremendous amount of pain. Take norco at 7 pm, another at 830 pm, still miserable. Take oxy at 1015 pm and starting to get a little relief. Getting very drowsy from all of the drugs. Sleep for 1.5 hours, take oxy at 1015 pm, norco at 1140 pm. Still awake and not getting much relief.
Monday, March 21, 2011
Day 1 (March 21)
Also posted on Health Board forum which is an excellent resource: http://www.healthboards.com/
General:
I've decided to create a blog to help others understand what they may be able to expect post-surgery. From what I understand, this procedure was more painful for me immediately following the procedure than for most people. On the flip side, I've also been able to switch from taking pain killers all day to taking them on an as needed basis 10 days after surgery (most report 14 days at bare minimum). I attribute it to a reduced effectiveness of pain killers due to other conditions (more about that below). I've also been told it's typically more painful for men than women, don't know why. This just gives you a worst case scenario (from a pain perspective) and hopefully some ideas to make your experience less traumatic.
I had a calcaneal osteotomy, lateral ligament repair (modified brostrom procedure), removal of bone fragments, and calf lengthening (gastrocnemius slide) on my left ankle. If you're reading this and don't know what all of those are, here you go:
Calcaneal osteotomy: http://www.footeducation.com/calcaneal-osteotomy
Ligament repair: http://en.wikipedia.org/wiki/Brostr%C3%B6m_procedure
Calf lengthening: http://www.footeducation.com/gastrocnemius-slide-strayer-procedure
My surgery was Monday March 21, 2011 at 9 am. I'll recap what happened Monday but first some background. I will continue to update pages as I recall information.
Background:
I'm a 34 year old male and rolled my left ankle July 2010. I'm 240 lbs and 6'5" tall. Went to ER and x-ray was negative for fracture. Gave me air splint and crutches. Saw an orthopedic surgeon a week later who took new x-rays without significant result. Tried conservative treatment (immobilization in cam walker) for 2 months followed by therapy. At the beginning of October, the doctor said that we should revisit the problem in a year if there is continued pain and instability.
I saw a different orthopedic surgeon (a specialist focused on cartilage grafting, regeneration, etc.) for an ongoing problem with my knees (see below). Asked him about ankle and had an MRI done that showed torn ligaments and fracture. He recommended trying the boot again for one month. He said he could continue treatment but recommended a foot & ankle specialist.
*I have a history knee problems including patella alta which has resulted in the wearing away of the cartilage within both knees. There are grooves worn into the bone under the knee cap. It is tolerable 95% of the time and I mostly have issues when kneeling, using stairs, or sitting for long periods of time. I have had 2 arthroscopic surgeries on the left knee, one included patellar drilling to cause blood to fill in the hole on underside of kneecap (to serve as pseudo-cartilage). I tolerated the procedure well and had limited post surgical pain. I have an ongoing script for Norco (10/325) and typically take 1.5 and then the other half 1 hour later. I don't usually take more than 2 per week. I mention this as it may have impacted the effectiveness of the post-surgical pain killers.
I have also had 2 surgeries on my right ankle to repair ligaments damaged in a car accident. I tolerated both procedures very well and had little pain.
The Surgeon:
The surgeon is a highly respected foot & ankle specialist. He has been the president of the state board of foot & ankle specialists a number of times. He is published and highly recommended. He performed the two surgeries on my other ankle in 2002.
Pre-surgery appointment:
Doctor examined ankle and felt the ligaments were torn and stretched. He had me perform a number of exercises and asked if I feel like I walk on the outside of my foot. He also questioned how stable I feel. He then said that he strongly recommends a calcaneal osteotomy. He said it is not to the point that he would insist upon it but that it will greatly help my ligaments and overall joint health in the long run. He said it is a realignment of the ankle. Unfortunately, I did not ask very many questions as I was pretty sure I just wanted to get the ligaments fixed. I told him I would like to do some research and would get back to him. He also recommended the calf lengthening (gastrocnemius slide). He mentioned it was not a common procedure when he performed my previous surgeries (on my other ankle in 2002) but highly recommended it. I agreed to the surgery to fix ligaments and calf lengthening with the understanding that I would confirm the calcaneal osteotomy in a few days. We scheduled the surgery for March 21st at an outpatient surgical center. Recovery time was explained to be 2 weeks no weight bearing, 3 weeks walking cast, 3 weeks cam walker (boot).
I later discussed calcaneal osteotomy with a family friend that is a retired orthopedic surgeon. He recommended the procedure. At this point, I really should have done more research on the topic but I did not. If I had known what it entailed, I probably would have decided to pass. The recovery period (which I did not know until post surgery) is expected to be 8 weeks no weight bearing, 4 weeks in cam walker, and months of therapy. I contacted the surgeons office and confirmed that I would like to proceed with the calcaneal osteotomy as well.
Surgery:
Arrived at surgical center at 8 am with procedure scheduled for 9:15. Was told it would take just over an hour and then would be in recovery for a few hours before being sent home. I completed paperwork and was led to pre-op area where a nurse put in IV. Anesthesiologist visited and explained what would happen. He said the doctor has recommended a nerve block to help with the pain. He then gave me something to relax. Next I rolled onto my stomach and he injected the back of my leg to numb the area. He then inserted a larger needle and injected the area round the nerve with a solution to numb it. All I really felt was some pressure, not bad at all. The doctor then arrived and explained the procedures and what to expect. He explained the calcaneal osteotomy and that really freaked me out. Unfortunately, at this point I figured I would just go through with it. I went to surgery, anesthesiologist gave me some more meds to calm me down, then knocked me out. Woke up a few hours later, leg completely numb and with a head ache. At that point, I could move none of my toes.
Post Surgery:
Left surgical center at 2 pm, stopped at pharmacy to fill prescriptions. Doctor forgot to write dosage on script for percocet (oxycodone and acetaminophen) so the pharmacist could not fill. As it's a class II drug, they can not fax or call it in. Fortunately, the doc had written a proper script for Norco (10/325) so I was able to fill that. I requested the new script to be oxycodone only as a way to avoid too much acetaminophen. This may be the smartest thing I did.
Medication plan:
Either take 2 norco (10/325) and 1 oxycodone (5 mg) for breakthrough pain or 2 oxycodone and 1 norco for breakthrough pain. Every 4 - 6 hours. The biggest variable is the nerve block and when it will wear off. Everyone metabolizes differently. For some it lasts 8 hours and others 36. They recommend starting pain medicine the evening after surgery in case the nerve block wears off in middle of the night. They also want to make sure the pain does not get ahead of you because it can be difficult to gain control.
Home:
Home around 3 pm. No pain all day. Began to feel a few tingles in foot in the evening. Once again, no idea if nerve block is wearing off or not. I took 1.5 norco at 9:30 pm.
Biggest recommendation I can make is to keep a log of when you take your medications. It is the smartest thing to do to avoid taking too much or too little.
General:
I've decided to create a blog to help others understand what they may be able to expect post-surgery. From what I understand, this procedure was more painful for me immediately following the procedure than for most people. On the flip side, I've also been able to switch from taking pain killers all day to taking them on an as needed basis 10 days after surgery (most report 14 days at bare minimum). I attribute it to a reduced effectiveness of pain killers due to other conditions (more about that below). I've also been told it's typically more painful for men than women, don't know why. This just gives you a worst case scenario (from a pain perspective) and hopefully some ideas to make your experience less traumatic.
I had a calcaneal osteotomy, lateral ligament repair (modified brostrom procedure), removal of bone fragments, and calf lengthening (gastrocnemius slide) on my left ankle. If you're reading this and don't know what all of those are, here you go:
Calcaneal osteotomy: http://www.footeducation.com/calcaneal-osteotomy
Ligament repair: http://en.wikipedia.org/wiki/Brostr%C3%B6m_procedure
Calf lengthening: http://www.footeducation.com/gastrocnemius-slide-strayer-procedure
My surgery was Monday March 21, 2011 at 9 am. I'll recap what happened Monday but first some background. I will continue to update pages as I recall information.
Background:
I'm a 34 year old male and rolled my left ankle July 2010. I'm 240 lbs and 6'5" tall. Went to ER and x-ray was negative for fracture. Gave me air splint and crutches. Saw an orthopedic surgeon a week later who took new x-rays without significant result. Tried conservative treatment (immobilization in cam walker) for 2 months followed by therapy. At the beginning of October, the doctor said that we should revisit the problem in a year if there is continued pain and instability.
I saw a different orthopedic surgeon (a specialist focused on cartilage grafting, regeneration, etc.) for an ongoing problem with my knees (see below). Asked him about ankle and had an MRI done that showed torn ligaments and fracture. He recommended trying the boot again for one month. He said he could continue treatment but recommended a foot & ankle specialist.
*I have a history knee problems including patella alta which has resulted in the wearing away of the cartilage within both knees. There are grooves worn into the bone under the knee cap. It is tolerable 95% of the time and I mostly have issues when kneeling, using stairs, or sitting for long periods of time. I have had 2 arthroscopic surgeries on the left knee, one included patellar drilling to cause blood to fill in the hole on underside of kneecap (to serve as pseudo-cartilage). I tolerated the procedure well and had limited post surgical pain. I have an ongoing script for Norco (10/325) and typically take 1.5 and then the other half 1 hour later. I don't usually take more than 2 per week. I mention this as it may have impacted the effectiveness of the post-surgical pain killers.
I have also had 2 surgeries on my right ankle to repair ligaments damaged in a car accident. I tolerated both procedures very well and had little pain.
The Surgeon:
The surgeon is a highly respected foot & ankle specialist. He has been the president of the state board of foot & ankle specialists a number of times. He is published and highly recommended. He performed the two surgeries on my other ankle in 2002.
Pre-surgery appointment:
Doctor examined ankle and felt the ligaments were torn and stretched. He had me perform a number of exercises and asked if I feel like I walk on the outside of my foot. He also questioned how stable I feel. He then said that he strongly recommends a calcaneal osteotomy. He said it is not to the point that he would insist upon it but that it will greatly help my ligaments and overall joint health in the long run. He said it is a realignment of the ankle. Unfortunately, I did not ask very many questions as I was pretty sure I just wanted to get the ligaments fixed. I told him I would like to do some research and would get back to him. He also recommended the calf lengthening (gastrocnemius slide). He mentioned it was not a common procedure when he performed my previous surgeries (on my other ankle in 2002) but highly recommended it. I agreed to the surgery to fix ligaments and calf lengthening with the understanding that I would confirm the calcaneal osteotomy in a few days. We scheduled the surgery for March 21st at an outpatient surgical center. Recovery time was explained to be 2 weeks no weight bearing, 3 weeks walking cast, 3 weeks cam walker (boot).
I later discussed calcaneal osteotomy with a family friend that is a retired orthopedic surgeon. He recommended the procedure. At this point, I really should have done more research on the topic but I did not. If I had known what it entailed, I probably would have decided to pass. The recovery period (which I did not know until post surgery) is expected to be 8 weeks no weight bearing, 4 weeks in cam walker, and months of therapy. I contacted the surgeons office and confirmed that I would like to proceed with the calcaneal osteotomy as well.
Surgery:
Arrived at surgical center at 8 am with procedure scheduled for 9:15. Was told it would take just over an hour and then would be in recovery for a few hours before being sent home. I completed paperwork and was led to pre-op area where a nurse put in IV. Anesthesiologist visited and explained what would happen. He said the doctor has recommended a nerve block to help with the pain. He then gave me something to relax. Next I rolled onto my stomach and he injected the back of my leg to numb the area. He then inserted a larger needle and injected the area round the nerve with a solution to numb it. All I really felt was some pressure, not bad at all. The doctor then arrived and explained the procedures and what to expect. He explained the calcaneal osteotomy and that really freaked me out. Unfortunately, at this point I figured I would just go through with it. I went to surgery, anesthesiologist gave me some more meds to calm me down, then knocked me out. Woke up a few hours later, leg completely numb and with a head ache. At that point, I could move none of my toes.
Post Surgery:
Left surgical center at 2 pm, stopped at pharmacy to fill prescriptions. Doctor forgot to write dosage on script for percocet (oxycodone and acetaminophen) so the pharmacist could not fill. As it's a class II drug, they can not fax or call it in. Fortunately, the doc had written a proper script for Norco (10/325) so I was able to fill that. I requested the new script to be oxycodone only as a way to avoid too much acetaminophen. This may be the smartest thing I did.
Medication plan:
Either take 2 norco (10/325) and 1 oxycodone (5 mg) for breakthrough pain or 2 oxycodone and 1 norco for breakthrough pain. Every 4 - 6 hours. The biggest variable is the nerve block and when it will wear off. Everyone metabolizes differently. For some it lasts 8 hours and others 36. They recommend starting pain medicine the evening after surgery in case the nerve block wears off in middle of the night. They also want to make sure the pain does not get ahead of you because it can be difficult to gain control.
Home:
Home around 3 pm. No pain all day. Began to feel a few tingles in foot in the evening. Once again, no idea if nerve block is wearing off or not. I took 1.5 norco at 9:30 pm.
Biggest recommendation I can make is to keep a log of when you take your medications. It is the smartest thing to do to avoid taking too much or too little.
Sunday, March 20, 2011
Suggestions for Pre & Post Surgery
This will be updated as necessary....
1. Do not get a calcaneal osteotomy unless it is absolutely necessary. Best case scenario (highly unlikely), you will able to return to work after 3 weeks. It takes most people 10 - 12 weeks.
2. Get a nerve block. I can't imagine the pain without one.
3. Request to stay at least one night in the hospital (until the nerve block wears off). For some people, the pain after the nerve block wears off can not be controlled with pills. You absolutely must stay ahead of the pain.
4. Keep a medication list where you track when you take your meds. You do not want to risk over dose and probably will not be able to remember when you took each dose.
5. For guys, get a urinal to pee in for the first week or two after surgery. The pain when standing is miserable.
6. Have multiple water bottles by your bed side. The drugs dehydrate you pretty bad. Also keep some bread or something so you don't have to take pills on an empty stomach.
7. Baby your foot/ankle. If you can keep it elevated, it will be much less painful and will heal faster. You absolutely do not want to risk putting weight on it until cast is off (6-8 weeks).
8. Everyone that has the procedure goes through a different experience. The Healthboards forum is good to get others perspective but keep in mind that most of the people that post have had bad experiences. So take what they say with a grain of salt. My experience was horrible but yours may be much better.
1. Do not get a calcaneal osteotomy unless it is absolutely necessary. Best case scenario (highly unlikely), you will able to return to work after 3 weeks. It takes most people 10 - 12 weeks.
2. Get a nerve block. I can't imagine the pain without one.
3. Request to stay at least one night in the hospital (until the nerve block wears off). For some people, the pain after the nerve block wears off can not be controlled with pills. You absolutely must stay ahead of the pain.
4. Keep a medication list where you track when you take your meds. You do not want to risk over dose and probably will not be able to remember when you took each dose.
5. For guys, get a urinal to pee in for the first week or two after surgery. The pain when standing is miserable.
6. Have multiple water bottles by your bed side. The drugs dehydrate you pretty bad. Also keep some bread or something so you don't have to take pills on an empty stomach.
7. Baby your foot/ankle. If you can keep it elevated, it will be much less painful and will heal faster. You absolutely do not want to risk putting weight on it until cast is off (6-8 weeks).
8. Everyone that has the procedure goes through a different experience. The Healthboards forum is good to get others perspective but keep in mind that most of the people that post have had bad experiences. So take what they say with a grain of salt. My experience was horrible but yours may be much better.
Medical Groups, Facilities, Links, Blogs
As a reference, here are the medical groups and facilities involved in this experience. I have also listed some other blogs about similar surgeries that may help.
Orthopaedic/Orthopedic Associates of Michigan (Grand Rapids, MI)
http://www.oamichigan.com/
Battle Creek Orthopaedic and Sports Medicine Clinic (now Southern Michigan Orthopaedics) (Battle Creek, MI)
http://www.bcortho.com/
http://w.mawebcenters.com/somiorthocom/
Deniel PLC (Grand Rapids, MI)
http://www.denielplc.com/
Lake Regional Health System (Lake Ozark, MO)
http://www.lakeregional.com/Locations/PrimaryCare/LakeOzark
Midtowne Surgery Center (operated by Metro Health in the Women's Health Center building) (Grand Rapids, MI)
http://www.metrohealth.net/
http://www.womenshealthcenterofwestmichigan.com/
Spectrum Health Blodgett Hospital (Grand Rapids, MI)
http://www.spectrumhealth.org/landing_custom.cfm?id=2814
The Center for Physical Rehabilitation (Grand Rapids, MI)
http://pt-cpr.com/
Great forum to share experiences and get answers from others:
http://www.healthboards.com/boards/foot-problems/
Blogs:
Calcaneal Osteotomy:
http://purplejetx.blogspot.com/
Calcaneal Osteotomy:
http://cokar-calcanealosteotomysurgery.blogspot.com/
Calcaneal Osteotomy:
http://annacmorrison.blogspot.com/2009/06/calcaneal-osteotomy-et-al.html
Calcaneal Osteotomy:
http://calcanealosteotomy2008.blogspot.com/
Calcaneal Osteotomy plus Bunionectomy:
http://kristysfootsurgery.blogspot.com/
Calcaneal Osteotomy plus other procedures:
http://kristysfootsurgery.blogspot.com/2012/02/day-43-doctors-updatetears.html
PTTD (similar):
http://pttdfootsurgery.wordpress.com/pttd-links/researching-socializing/
Orthopaedic/Orthopedic Associates of Michigan (Grand Rapids, MI)
http://www.oamichigan.com/
Battle Creek Orthopaedic and Sports Medicine Clinic (now Southern Michigan Orthopaedics) (Battle Creek, MI)
http://www.bcortho.com/
http://w.mawebcenters.com/somiorthocom/
Deniel PLC (Grand Rapids, MI)
http://www.denielplc.com/
Lake Regional Health System (Lake Ozark, MO)
http://www.lakeregional.com/Locations/PrimaryCare/LakeOzark
Midtowne Surgery Center (operated by Metro Health in the Women's Health Center building) (Grand Rapids, MI)
http://www.metrohealth.net/
http://www.womenshealthcenterofwestmichigan.com/
Spectrum Health Blodgett Hospital (Grand Rapids, MI)
http://www.spectrumhealth.org/landing_custom.cfm?id=2814
The Center for Physical Rehabilitation (Grand Rapids, MI)
http://pt-cpr.com/
Great forum to share experiences and get answers from others:
http://www.healthboards.com/boards/foot-problems/
Blogs:
Calcaneal Osteotomy:
http://purplejetx.blogspot.com/
Calcaneal Osteotomy:
http://cokar-calcanealosteotomysurgery.blogspot.com/
Calcaneal Osteotomy:
http://annacmorrison.blogspot.com/2009/06/calcaneal-osteotomy-et-al.html
Calcaneal Osteotomy:
http://calcanealosteotomy2008.blogspot.com/
Calcaneal Osteotomy plus Bunionectomy:
http://kristysfootsurgery.blogspot.com/
Calcaneal Osteotomy plus other procedures:
http://kristysfootsurgery.blogspot.com/2012/02/day-43-doctors-updatetears.html
PTTD (similar):
http://pttdfootsurgery.wordpress.com/pttd-links/researching-socializing/
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